Pituitary hormone circadian rhythm alterations in cirrhosis patients with subclinical hepatic encephalopathy

Dimitrios Velissaris, Menelaos Karanikolas, Andreas Kalogeropoulos, Ekaterini Solomou, Panagiotis Polychronopoulos, Konstantinos Thomopoulos, Chrissoula Labropoulou-Karatza

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Aim: To analyze pituitary hormone and melatonin circadian rhythms, and to correlate hormonal alterations with clinical performance, hepatic disease severity and diagnostic tests used for the detection of hepatic encephalopathy in cirrhosis. Methods: Twenty-six patients with cirrhosis were enrolled in the study. Thirteen patients hospitalized for systemic diseases not affecting the liver were included as controls. Liver disease severity was assessed by the Child-Pugh score. All patients underwent detailed neurological assessment, electroencephalogram (EEG), brain magnetic resonance imaging (MRI), assays of pituitary hormone, cortisol and melatonin, and complete blood chemistry evaluation. Results: Pituitary hormone and melatonin circadian patterns were altered in cirrhosis patients without clinical encephalopathy. Circadian hormone alterations were different in cirrhosis patients compared with controls. Although cortisol secretion was not altered in any patient with cirrhosis, the basal cortisol levels were low and correlated with EEG and brain MRI abnormalities. Melatonin was the only hormone associated with the severity of liver insufficiency. Conclusions: Abnormal pituitary hormone and melatonin circadian patterns are present in cirrhosis before the development of hepatic encephalopathy. These abnormalities may be early indicators of impending hepatic encephalopathy. Factors affecting the human biologic clock at the early stages of liver insufficiency require further study.

Original languageEnglish
Pages (from-to)4190-4196
Number of pages7
JournalWorld Journal of Gastroenterology
Issue number26
StatePublished - 2008


  • Circadian rhythms
  • Liver cirrhosis
  • Melatonin
  • Minimal hepatic encephalopathy
  • Pituitary hormones


Dive into the research topics of 'Pituitary hormone circadian rhythm alterations in cirrhosis patients with subclinical hepatic encephalopathy'. Together they form a unique fingerprint.

Cite this